Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/45

Click to flip

45 Cards in this Set

  • Front
  • Back
Respiratory Acidosis

What is it?
•Excess carbon dioxide or CO2 retention
Respiratory Acidosis

Possible Causes?
•CNS depression from drugs, injury, or disease

•Asphyxia

•Hypoventilation related to a disease
Respiratory Acidosis

Symptoms?
•Restlessness
•Confusion
•Coma
•Headaches
•SOB and tachypnea
•Decreased reflexes
•Hypoxemia
•Tachycardia and arrhythmias
Respiratory Acidosis

Treatment?
•Bronchodilator
•Oxygen
•Treat hyperkalemia
•Treat infection
•Treat underlying causes
•Chest CPT
Respiratory Alkalosis

What is it?
•excess CO2 excretion
Respiratory Alkalosis

Possible Causes?
•Hyperventilation from anxiety, pain, or improper ventilator settings

•Respiratory stimulation due to drugs, disease, hypoxia, or fever

•Gram negative bacteremia
Respiratory Alkalosis

Symptoms?
•Deep and rapid respirations
•Dizziness
•Agitation
•Circumoral and peripheral paresthesia

•Carpopedal spasms, twitching, and muscle weakness
Respiratory Alkalosis

Treatment?
•Treat underlying cause: sepsis, salicylate overdose

•Hypoxia: give O2
•Anxiety: give a sedative
•Hyperventilation: breathe into a paper bag

•Adjust ventilator settings
Metabolic Acidosis

What is it?
bicarbonate or HCO3 loss
with acid retention
Metabolic Acidosis

Possible Causes?
•Bicarbonate depletion from diarrhea

•Excess production of organic acids from hepatic disease, endocrine disorders, shock, or drug intoxication

•Inadequate excretion of acids from renal disease
Metabolic Acidosis

Symptoms?
•Headache and lethargy
•Kussmaul’s respirations
•Hypotension
•Stupor, possibly leading to coma and death

•Anorexia
•N/V/D
•Dehydration
•Warm, flushed skin
•Fruity-smelling breath
Metabolic Acidosis

Treatment?
•Mechanical ventilation is usually the first line of therapy

•Treat DKA
•Administer sodium bicarbonate
•Dialysis
Metabolic Alkalosis

What is it?
•HCO3 retention and acid loss
Metabolic Alkalosis

Possible Causes?
•Loss of hydrochloric acid from prolonged vomiting or gastric suctioning

•Loss of potassium from increased renal excretion (as in diuretic therapy) or steroids

•Excessive alkali ingestion
Metabolic Alkalosis

Symptoms?
•Picking at bedclothes
•Twitching
•Confusion
•N/V/D
•Trousseau’s sign
•Slow, shallow respirations
Metabolic Alkalosis

Treatment?
•D/C thiazide diuretics and NG suctioning

•Give an antiemetic for N/V
•Meds to excrete bicarb
Sodium

Symbol?
mEq/L?
Na+

136-145 mEq/L
Sodium

What it does?
•ECF cation

•A shift in Na, triggers a fluid volume change to restore normal solute and water ratios

•Helps maintain acid-base balance

•Activates nerve and muscle cells, involved in muscle contraction and the Na+/K+ pump

•Influences H2O distribution with Cl-

•Regulated by the kidney through tubular reabsorption

•Aldosterone , a hormone secreted by the adrenal cortex, works to increase the reabsorption of Na+ by the kidney

•Natriuretic peptides increase Na+ and water excretion
Sodium

Hypo?
•SIADH-decreased renal excretion of water

•Diuretics in combo with a patient on a low Na+ diet

•Excessive sweating
•GI wound drainage

•Decreased secretion of aldosterone

•Renal disease
•Burns
Sodium

Hyper?
•Diabetes Insipidus
•Hyperaldosteronism
•Cushing’s syndrome
•Inadequate fluid intake
•High protein feedings without free water

•Osmotic diuretics
Sodium

Symptoms?
Hypo:
•Sleepiness
•Weakness
•Lethargy
•N/V or anorexia
•Behavioral and personality changes
•Decreased tendon reflexes
•Headache

Hyper:
•Increased thirst
•Irritability, restlessness
confusion, agitation

Both:
•Seizures
•Coma
Sodium

Treatment?
Hypo:
•Fluid restriction

Hyper:
•Push fluids
•D5W
•Inspect for edema

Both:
•Monitor I/O, VS, Wt., lab values, urine Na+, specific gravity
Chloride

Symbol?
mEq/L
Cl-

98-106 mEq/L
Chloride

What it does?
•Main ECF anion
•ECF osmolality
•Affects body pH by playing a vital role in acid-base balance, combining with H- ions to produce HCL

•Passive transport, follows Na+
Chloride

Hypo?
•Prolonged vomiting, excessive GI suctioning, diarrhea, perfuse sweating

•Diuretics
•Low sodium diets
•Excessive administration of bicarb
Chloride

Hyper?
•Hypernatremia
•Metabolic acidosis
•Ingestion of salicylate, ethylene glycol, or methanol
Chloride

Symptoms?
Hypo:
•Hypoventilation
•Tetany
•Paresthesia of the extremities
•Restless, confusion, convulsions

Hyper:
•Hyperventilation to blow off excess carbon dioxide
•Hypotension
•Decreased cardiac output
•Peripheral vasodilation
•Headache
•Lethargy
Chloride

Treatment?
Hypo:
•Increase NaCL in the diet
•Correct GI symptoms
•Seizure precautions

Hyper:
•Correct fluid imbalance by giving IV fluids
•Give sodium bicarb and corrects pH
•Monitor patient’s level of consciousness and respiratory status
Potassium

Symbol?
mEq/L?
K+

3.5-5 mEq/L
Potassium

What it does?
•Main ICF cation
•Regulates cell excitablility and membrane potential for muscle contraction, cardiac muscle contraction, and nerve impulse conduction.

•Na+/K+ pump
•Affects the cell’s electrical status

•ICF osmolality
•K+ and insulin are required to move glucose into the ICF and for metabolism of Carbohydrates and proteins.

•Kidneys excrete 80% of the body’s potassium, and 20% through the bowel and sweat glands. K+ must be replaced every day.

•90% of K+ is reabsorbed by the proximal tubule and Loop of Henle. The distal tubule secretes K+ and determines the amount of K+ excreted from the body.

•Aldosterone also plays a major factor in K+ regulation

•Insulin helps regulate plasma K+ by moving K+ into the liver and muscle cells
Potassium

Hypo?
•Diarrhea
•GI suction and drainage
•Diuretics
•Some antibiotics
•Polyuria with diabetes
•AML
•Cushing’s syndrome
•Severe, even fatal, hypokalemia can result if insulin is administered without also providing K+ supplements
Potassium

Hyper?
•Burns and renal failure
•Stored whole blood
•Addison’s Disease
•Interstitial nephritis
•K+ sparing diuretics
•Excessive intake orally, meds, or IV, especially with renal disease present

•ACE Inhibitors
Potassium

Symptoms?
Hypo:
•Muscle weakness and cramps, fatigue, decreased tendon reflexes
•Postural hypotension
•Constipation
•EKG changes and arrhythmias
•Confusion

Hyper:
•EKG changes and arrhythmias
•Nausea, diarrhea, hyperactive bowel sounds with intermittent colic, numbness/tingling of the face, tongue, feet, or hands
•Fatigue, drowsiness
•Irritability, mental confusion
Potassium

Treatment?
Hypo:
•Replace K+ orally or IV

Hyper:
•Kayxelate
•Insulin, bicarb, and dextrose fluids
•Dialysis
•Goal: increase excretion and move the potassium into the cells

Both:
•Monitor I/O, heart monitor, labs, mental status
Total Calcium

Symbol?
mg/dl?

Other form of calcium?

mg/dl?
Ca++

9-10.5 mg/dl

Ionized (free) serum Ca++

4.5-5.6 mg/dl
Total Calcium

What it does?
•Found in equal amounts in ECF and ICF

•Major cation for bones and teeth: important for their development and maintenance

•Found in cell membranes and maintains their shape, and is required for muscle contraction, necessary for the synaptic release of neurotransmitters for transition of nerve impulses, cardiac and skeletal muscle contractions are initiated by release of calcium, Ca++/Na+/K+/Mg++ help to maintain muscle tone

•Aids in coagulation
•Ca++ absorption requires a specific protein called calbindin. Absorption is greatest in the ileum, duodenum, and the proximal jejunum where the pH is more acidic and calbindin is present. Only 20-30% of Ca++ is absorbed. Ca++ requires vit. D for absorption through the intestines, reabsorption of Ca++ in the kidneys, and resorption of Ca++ through the bone. Ca++ competes with zinc, manganese, magnesium, copper, and iron for absorption. Ca++ is excreted in the feces, urine, and sweat. It is regulated by parathyroid hormone (PTH), thyrocalcitonin (TCT), the blood pH, and vit. D.
Total Calcium

Hypo?
•Acute pancreatitis
•Massive transfusion
•Decrease in PTH or removal of the parathyroid gland. PTH is secreted in response to a low serum Ca++ level, and acts to raise the Ca++ level. PTH makes the kidneys reabsorb Ca++ and excrete Phos, makes the kidneys covert vit. D to an active form which increases the GI absorption of Ca++, releases Ca++ from bone storage called resorption-makes osteocasts break down bone to release Ca++ into the plasma.

•Vit. D deficiency
•Cancer of the bone
Total Calcium

Hyper?
•Hyperparathyroidism, thyrotoxicosis, adrenal insufficiency, cancers, excessive vit. D or A intake, Paget’s disease, hypophosphatemia, multiple fractures, prolonged immobilization, prolonged use of aluminum containing antacids
•Acidosis

•TCT (calcitonin) is secreted in response to a high serum Ca++ level, and acts to reduce it. It is released by the thyroid gland in response to a high serum Ca++. It’s major effect is to inhibit bone resorption slowing the osteoblastic activity, increases bone uptake of Ca++, decreases vit. D absorption in the GI tract, and causes the kidneys to inhibit Ca++ reabsorption resulting in
increased urinary excretion.

•Of note: The pH of the blood also affects the serum Ca++ level, because both hydrogen and Ca++ compete for binding sites on albumin. With alkalosis, Ca++ binds with albumin and the ionized Ca++ level decreases, hypocalcemia. With acidosis, less Ca++ binds to albumin, and the ionized Ca++ level rises, hypercalcemia.
Total Calcium

Symptoms?
Hypo:
•Confusion, convulsions, insomnia
•Paresthesias around the mouth and hands
•Carpopedal spasm, tetany
•Hyperreflexia
•Brittle nails, osteoporosis, periodontal disease
•Diarrhea
•Positiove Chvostek and Trousseau signs
•Cardiac arrhythmias

Hyper:
•N/V
•Constipation
•Confusion, weakness, lethargy
•Polydipsia, polyuria, dehydration
•Decreased deep tendon reflexes
•Bone pain
•Cardiac arrhythmias or arrest
Total Calcium

Treatment?
Hypo:
•D/C meds known to lower Ca++
•Administer Ca++
•Treat low Mg++ level
•Treat causes
•Monitor heart monitor
•Calcitriol/Vit. D.

Hyper:
•D/C Ca++ meds
•Treat causes
•IV NS with Lasix
•Phosphates
•Calcitonin
•Meds for bone pain, N/V
•Laxatives
•Heart monitor
Phosphate Serum Phosphorous

mg/dl?
3-4.5
mg/dl
Phosphate Serum Phosphorous

What it does?
•Note: phosphorous and calcium are generally opposite, high phosphorous, low Ca++
Phosphate Serum Phosphorous

Hypo?
•Intestinal malabsorption
•Increased renal excretion
•Vit. D deficiency causing decreased absorption

•Increased use of MG++ and AL- containing antacids

•Alcohol abuse
Phosphate Serum Phosphorous

Hyper?
•Occurs with significant loss of glomerular filtration, cancer with chemotherapy
Phosphate Serum Phosphorous

Symptoms?
Hypo:
•Causes reduced oxygen transport by RBCs, hypoxia can occur, also bradycardia

•Dysfunctions in WBCs and platelets causing increased risk of infection and bleeding.

•Affects nerve and muscle function

•Bone resorption occurs, which may lead to rickets or osteomalacia

Hyper:
•Symptoms are generally those of hypocalcemia